Michael Widjaja, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

56540 Issued in KY

Practice address

299 Kings Daughters Dr
Frankfort, KY 40601-4186

Phone

(502) 875-5240

NPI assigned

Jun 27, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospital Medicine Services of Ky, LLCGroup PAC ID 0244695104, 34 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hospice of the Bluegrass, Inc Dba Bluegrass Care N Hospice, Lexington, KY, CCN 181500
• Frankfort Regional Medical Center Hospital, Frankfort, KY, CCN 180127
• UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Hospital, Louisville, KY, CCN 180040

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hospital Medicine Services of Ky, LLC

  • Hospitalist Physician
  • Bowling Green, KY
  • NPI 1215634373
  Medicare reassignment Care Compare group NPD
• Frankfort Hospital, Inc.

  • General Acute Care Hospital
  • Frankfort, KY
  • NPI 1427095488
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Frankfort Hospital, Inc.

  • General Acute Care Hospital
  • Frankfort, KY
  • NPI 1427095488
  Care Compare affiliation
• Hospice of the Bluegrass, Inc

  • Community Based Hospice Care Agency
  • Lexington, KY
  • NPI 1861538209
  Care Compare affiliation
• Uofl Health-Louisville Inc

  • Rehabilitation Hospital Unit
  • Louisville, KY
  • NPI 1013784859
  Care Compare affiliation
• Uofl Health-Louisville Inc

  • Rehabilitation Hospital Unit
  • Louisville, KY
  • NPI 1033752704
  Care Compare affiliation
• Uofl Health-Louisville Inc

  • General Acute Care Hospital
  • Louisville, KY
  • NPI 1093341497
  Care Compare affiliation
• Uofl Health-Louisville Inc

  • Rehabilitation Hospital Unit
  • Louisville, KY
  • NPI 1104469873
  Care Compare affiliation
• Uofl Health-Louisville Inc

  • Rehabilitation Hospital Unit
  • Louisville, KY
  • NPI 1114591039
  Care Compare affiliation
• Uofl Health-Louisville Inc

  • General Acute Care Hospital
  • Louisville, KY
  • NPI 1124654512
  Care Compare affiliation
• Uofl Health-Louisville Inc

  • Rehabilitation Hospital Unit
  • Louisville, KY
  • NPI 1124661897
  Care Compare affiliation
• Uofl Health-Louisville Inc

  • General Acute Care Hospital
  • Louisville, KY
  • NPI 1144856543
  Care Compare affiliation
• Uofl Health-Louisville Inc

  • Rehabilitation Hospital Unit
  • Louisville, KY
  • NPI 1376310110
  Care Compare affiliation
• Uofl Health-Louisville Inc

  • General Acute Care Hospital
  • Louisville, KY
  • NPI 1477189876
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1184285249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 MEETING ST APT 12209",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405094662",
            "telephone_number": "347-749-8428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 KINGS DAUGHTERS DR",
            "city": "FRANKFORT",
            "state": "KY",
            "postal_code": "406014186",
            "telephone_number": "502-875-5240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDJAJA",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-27",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "56540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phoebe Ann Wheelercrum
• Whispering Winds Community Living, Inc.
• Connie Gayle White, MD
• Teresa M. White, PT
• Andrea Denise Wickersham, PSY.D.
• Craig Burdette Wiggins, DMD
• Claire Ryan Wigglesworth, LAC
• Sandra Kaye Wilcox, M.S, CCC
• Samantha L Wilcoxson
• Amanda Wiley, APRN

• Internal Medicine Physician in Frankfort, KY
• Providers in Frankfort, KY by specialty
• Internal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.